2型糖尿病伴高同型半胱氨酸血症与内热证相关性研究  

Relationship between Type 2 Diabetes Mellitus with Hyperhomocysteinemia and Syndrome of Internal Heat

作　　者：张佳乐 薛哲哲 侠晨辉 王艺 吴巧茹 魏蜀吴 姜伟民 王文娜 王耀献[4] 孙卫卫[4] ZHANG Jia-le;XUE Zhe-zhe;XIA Chen-hui;WANG Yi;WU Qiao-ru;WEI Shu-wu;JLANG Wei-min;WANG Wen-na;WANG Yao-xian;SUN Wei-wei(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Xi'an No.1 Hospital,Xi'an Shaanxi 710001;The Second People's Hospital of Liaocheng,liaocheng Shandong 252699;Department of Nephrology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]西安市第一医院,陕西西安710001 [3]聊城市第二人民医院,山东聊城252699 [4]北京中医药大学东直门医院肾内科,北京100700

出　　处：《世界中西医结合杂志》2023年第12期2427-2432,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：中医药行业科研专项基金资助项目(201207012)。

摘　　要：目的探究2型糖尿病伴高同型半胱氨酸血症患者与内热证的相关性。方法对1480例2型糖尿病患者进行回顾性观察研究,收集患者的一般资料、临床指标、中医证候资料等,进行统计学分析。结果(1)与单纯T2DM组比较,HHcy+T2DM组患者年龄较大,差异有统计学意义(P<0.01),男性、吸烟、饮酒史及合并脑血管疾病所占比例较高,差异有统计学意义(P<0.01);WHR、Scr、SUA、MALB值较高,差异有统计学意义(P<0.05),HDL、FBG值较低,差异有统计学意义(P<0.05);且HHcy+T2DM组患者内热证所占比例较高,差异有统计学意义(P<0.01)。(2)与非内热证组比较,内热证组患者Hcy水平明显升高,两组比较,差异有统计学意义(P<0.01)。Spearman相关性分析显示,Hcy水平与T2DM内热证患者呈正相关关系,差异有统计学意义(P<0.05)。Logistic单因素分析显示,内热证与T2DM患者出现高同型半胱氨酸血症相关,差异有统计学意义(P<0.01)。结论2型糖尿病伴高同型半胱氨酸血症患者与内热证密切相关,在临床中,对于2型糖尿病患者,除应密切关注Hcy水平的变化,还应重视清热法的应用,为临床从热论治2型糖尿病合并高同型半胱氨酸血症提供了依据。Objective To investigate the relationship between type 2 diabetes mellitus(T2DM)with hyperhomocysteinemia(HHcy)and syndrome of internal heat.Methods A retrospective study was conducted on 1480 patients with T2DM.The general data,clinical indicators,and TCM syndrome data of the patients were collected and statistically analyzed.Results(1)The patients with HHcy+T2DM were older(P<0.01)and had higher proportions of males,smoking history,drinking history,and cerebrovascular disease(P<0.01),higher waist-to-hip ratio(WHR),serum creatine(Scr),serum uric acid(SUA),and urine microalbumin(MALB)(P<0.05),and lower high-density lipoprotein(HDL)and fasting blood glucose(FBG)(P<0.05)than the T2DM group.Moreover,the patients with the syndrome of internal heat accounted for a higher proportion in the patients with HHcy+T2DM than in the patients with only T2DM(P<0.01).(2)Compared with the patients without internal heat,those with internal heat had elevated homocysteine(Hcy)level(P<0.01).Spearman correlation analysis showed that Hcy level was positively correlated with T2DM patients with internal heat(P<0.05).The univariate Logistic analysis showed that internal heat was correlated with the occurrence of HHcy in T2DM patients(P<0.01).Conclusion The T2DM patients with HHcy are associated with the syndrome of internal heat.In clinical practice,attention should be paid to clearing heat in addition to the Hcy level of T2DM patients.This study provides a basis for the treatment of T2DM with HHcy from heat.

关 键 词：2型糖尿病 高同型半胱氨酸血症 内热证 从热论治 

分 类 号：R587.1[医药卫生—内分泌]